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Paradigm shift in Sweden from tonsillectomy to tonsillotomy for children with upper airway obstructive symptoms due to tonsillar hypertrophy

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Abstract

Tonsillotomy (TT) is now used more often than tonsillectomy (TE) for tonsil obstructive symptoms in Sweden. Both TE and TT give high patient satisfaction although TT results in fewer postoperative bleedings and shorter time when analgesics are needed. The objective of this study is to analyze the current prevalence of different tonsil surgery procedures, the rates of early and late bleeding and other complications. Data from the National Tonsil Surgery Register in Sweden were analyzed. Patients 1–15 years operated for symptoms due to tonsil hypertrophy were included. Surgical procedure, technique and bleedings during hospital stay were registered. Thirty days after surgery, unplanned contacts due to bleeding, infection or pain were reported as were symptom relief after 6 months. 24,083 patients were registered. Of the 10,826 children 1–15 years operated for obstructive symptoms, 64 % were TT or TT+A, and 34 % TE, TE+A. 69 % answered the 30-day questionnaire and 50 % the 6 months. Bleeding in hospital occurred in 1.38 %, late bleedings in 2.06 %: 3.7 % after TE+A, 0.8 % after TT+A. Differences in readmissions due to bleeding, number of days using analgesics, health care contacts due to pain and nosocomial infections were significant between TT and TE, but not differences with regard to symptom relief after 6 months.

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Authors and Affiliations

  1. Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden

    Elisabeth Hultcrantz

  2. Department of Medical and Health Sciences, Linköping University, Linköping, Sweden

    Elisabeth Ericsson

  3. Department of Anesthesia and Intensive Care, County Council of Östergötland, Linköping, Sweden

    Elisabeth Ericsson

  4. Ear-, Nose- and Throat Clinic, Aleris Sabbatsberg Hospital, Stockholm, Sweden

    Claes Hemlin & Anne-Charlotte Hessén-Söderman

  5. Ear-, Nose- and Throat Clinic, Capio Lundby Hospital, Gothenburg, Sweden

    Kristian Roos

  6. Ear-, Nose- and Throat Clinic, County Hospital Ryhov, Jönköping, Sweden

    Ola Sunnergren

  7. Ear-, Nose- and Throat Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden

    Joacim Stalfors

Authors
  1. Elisabeth Hultcrantz
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  2. Elisabeth Ericsson
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  3. Claes Hemlin
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  4. Anne-Charlotte Hessén-Söderman
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  5. Kristian Roos
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  6. Ola Sunnergren
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  7. Joacim Stalfors
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Correspondence to Elisabeth Hultcrantz.

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Hultcrantz, E., Ericsson, E., Hemlin, C. et al. Paradigm shift in Sweden from tonsillectomy to tonsillotomy for children with upper airway obstructive symptoms due to tonsillar hypertrophy. Eur Arch Otorhinolaryngol 270, 2531–2536 (2013). https://doi.org/10.1007/s00405-013-2374-7

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  • DOI: https://doi.org/10.1007/s00405-013-2374-7

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